Hospital test worth Rs 200 can rule out heart attacks

MUMBAI: Ruling out a heart attack or distinguishing it from acidity-related chest discomfort got a bit easier.

A British study, being published in the medical journal Lancet on Thursday morning, shows that a high sensitivity blood marker test done as soon as the patient gets into a hospital emergency room can provide the answer. “Heart attacks can be ruled out in two-thirds of people attending the emergency department,’’ said the Lancet report about the high sensitivity troponin I marker test.

In Indian hospital emergency rooms, this test has been available for about a year at prices ranging from Rs 200 to Rs 500, depending on the type of hospital and the kind of bed. “We have been doing this test twice —when the patient is brought in with chest pain and after three hours. The graph helps us establish with 99% accuracy whether or not the patient is suffering from or has suffered a heart attack,’’ said Dr Barnali Das of Kokilaben Hospital.

But British scientists, led by Dr Anoop Shah from the University of Edinburgh, say that the test needs to be done only once—immediately on admission—to firmly answer the heart-attack-or-not question.

“Until now there was no quick way to rule out a heart attack within the emergency department,” said Dr Shah in a press release put out by Lancet. “We have identified a cardiac troponin concentration (less than 5 nanogram per decilitre) below which patients are at very low risk of heart attack either during the admission or in the ensuing 30 days.’’ The study’s findings could dramatically reduce unnecessary hospital admissions and “provide substantial cost savings for healthcare providers”.

“Emergency rooms are busy places. If we can reduce the number of hours a patient spends in the ER, it will be helpful,’’ said Dr Das, who has just completed a study of 200 patients on the high sensitive troponin I test.

The test measures the level of troponin proteins in the blood. These proteins are released when the heart muscle has been damaged, like during a heart attack. “The more damage there is to the heart, the greater the amount of troponin there will be in the blood. Even a slight increase in the troponin level will often mean there has been some damage to the heart. Very high levels of troponin are a sign that a heart attack has occurred,’’ said the Lancet report.

Dr Prafulla Kerkar, who heads the cardiology department of civic-run KEM Hospital in Parel, said that the British findings need to be validated using large multi-centric studies.

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